Background and Objectives: Post-traumatic stress disorder (PTSD) is a condition affecting individuals exposed to trauma in the past. This article evaluates the prevalence of PTSD in practicing physicians and how it influences work performance. Methods: A review of the literature, followed by data extraction and meta-analysis were performed. Articles were searched for in PubMed, Web of Science, and Medline using keywords: («physician» AND «ptsd»), as well as Mesh-terms («stress disorders, post-traumatic» AND «physicians»). Since 1980, 1363 unique hits published in English were identified and filtered by pre-specified inclusion criteria to yield a sample of 110 full-text articles examining the prevalence of PTSD among healthcare workers. Among these, 9 articles represented an accurate examination of the prevalence of PTSD among physicians only. Information was extracted on the demographic, as well as PTSD prevalence data, from these studies for final comparison. Results: Across all studies (n = 9) we examined, the prevalence of PTSD among physicians of both genders (n = 1616) was 14.8%, and the range was between 4.4% to 28%. This estimation is higher than the general prevalence of PTSD in the adult population of 3-4%, yet lower than prevalence found among people traumatized by war or torture, a range of 20- 45%. Since only 50% of the studies examined here stratified PTSD prevalence among physicians by gender, we could not accurately conclude gender differences. Conclusions: Our findings prompt a need for further investigation into the development of support programs for healthcare providers, aimed at reducing the traumatic stress experienced by physicians at work (AU)

Background and Objectives: Even if verbal fluency deficits have been described in Schizophrenia, error pattern in this test has not been analyzed in detail in the literature. The pattern analysis of such errors could contribute to the understanding of the factors that influence poor task performance in schizophrenia. In this study we analyzed the intrusion and perseveration errors in verbal fluency tasks in patients with chronic schizophrenia. Methods: 87 patients diagnosed with Chronic Schizophrenia and 87 healthy controls were included in this investigation and were assessed with four Phonological and Semantic Verbal Fluency tasks. Results: The results of this study showed that at least half of schizophrenic patients produced perseverative errors on verbal fluency and about made intrusion errors. The severity of negative symptoms, the severity of Formal Thought Disorder and pharmacological variables were significant moderators to errors in Verbal Fluency performance (AU)

Background and Objectives: According to a number of psychiatrists, the decrease in the number of suicides can almost exclusively be ascribed to the increasing use of new antidepressants (ADs). Several ecological studies have been carried out to lend support to this claim; unfortunately, many of these started out from either methodologically or statistically flawed assumptions. The purpose of the current study is to demonstrate the examined relationships using complex time-series techniques on Hungarian national sample. Methods: When investigating the relationships between our time series, first we ensured their stationarity using several methods. We used two methods for the analysis involving several independent variables. Results: When using dynamic regression to ensure stationarity, the residuals of the suicide and AD time series showed a significant negative correlation. At the same time, when using the more robust technique of time series differentiation, the stationary time series showed no significant relationship between the use of antidepressants and suicide rates. Conclusions: The models fitting our data showed somewhat mixed results. The vagueness of ecological models is well demonstrated by the fact that even those sociological variables (number of divorces, alcohol consumption) failed to show a significant relationship with suicides here, which are usually significant in analyses using micro data (AU)

Background and Objectives: The aim of this study is to present a non-systematic narrative review of the published evidence on the association between mental health and sociodemographic and economic factors at individual- and at area-level. Methods: A literature search of PubMed and Web of Science was carried out to identify studies published between 2004 and 2014 on the impact of sociodemographic and economic individual or contextual factors on psychiatric symptoms, mental disorders or suicide. The results and methodological factors were extracted from each study. Results: Seventy-eight studies assessed associations between individual-level factors and mental health. The main individual factors shown to have a statistically significant independent association with worse mental health were low income, not living with a partner, lack of social support, female gender, low level of education, low income, low socioeconomic status, unemployment, financial strain, and perceived discrimination. Sixty-nine studies reported associations between area-level factors and mental health, namely neighbourhood socioeconomic conditions, social capital, geographical distribution and built environment, neighbourhood problems and ethnic composition. Conclusions: Most of the 150 studies included reported associations between at least one sociodemographic or economic characteristic and mental health outcomes. There was large variability between studies concerning methodology, study populations, variables, and mental illness outcomes, making it difficult to draw more than some general qualitative conclusions. This review highlights the importance of social factors in the initiation and maintenance of mental illness and the need for political action and effective interventions to improve the conditions of everyday life in order to improve population's mental health (AU)

Background and Objectives: Prefrontal cortex (PFC) dysfunctions leading to cognitive deficits refer to a core feature of schizophrenia spectrum disorders (SSD). This exploratory study compares the effect of SSD on two stages of maturation of PFC. Methods: Using functional magnetic resonance imaging (fMRI), we measured the brain correlates related to a verbal fluency task (a hallmark executive function test) in 12 patients with SSD: 6 adolescents (SSD-ado) and 6 adults (SSD-adu). Results: SSD-ado showed greater activation in insula, thalamus and hIP1 whereas SSDadu recruited more intensively precentral gyrus and temporal pole to resolve the task. Thus, adolescents with SSD seem to adopt less frontal mediated strategic processes. In contrast, adults seem to be able to use PFC mediated strategy despite the well-known deleterious effect of SSD on the PFC. Conclusions: This first exploratory study revealed that adults and adolescents with SSD seemed not to use the same strategy to resolve a verbal fluency task. Thus, despite the illness, which is known to have a deleterious influence on PFC, adult patients seem to be able to recruit these resources to perform an executive function task. Further studies are needed in order to confirm and extend these new and preliminary results (AU)

Background and Objectives: Some clinicians use different psychotherapeutic methods in combination in their practice. These combinations reflect the need for more rigorous research on the common pathways which these different therapy orientations may be utilizing, and one way to identify these pathways would be to investigate some core assessment tools or conceptual foundations of these two different approaches. Aim: The aim of the present study was to evaluate the relationship between defense mechanisms and cognitive distortions, and to identify the mediating role of cognitive distortions between defense styles and depression. Methods: A total of 342 female psychiatric outpatients aged 18 and older were recruited. A diagnostic interview and rating of the depression severity were undertaken, and the Cognitive Distortion Scales and the Defense Style Questionnaire were completed by the participants. Hierarchical regression analyses were conducted to test for the direct and indirect effects of the defense styles. Results: Cognitive distortions and defense mechanisms were both correlated with the severity of depression, but the correlations were stronger for the former. Conclusions: The findings are suggestive of the mediating effect of cognitive distortions between defense mechanisms and the severity of depression (AU)

Background and Objectives: Posttraumatic stress disorder (PTSD) caused by war trauma experiences affects veterans'; ability to meet their parental obligations, which can lead to the appearance of psychological and behavioral problems in their children. We explored, based on the parents'; assessment, whether the children of veterans with PTSD exhibit more psychological and behavioral problems and whether there are differences in relation to the age and sex of the child. Methods: The study group consisted of 91 children from 50 veterans receiving treatment for the war-related PTSD at the Psychiatric Department of the University Clinical Hospital Mostar. The control group consisted of 98 children of 50 war veterans without PTSD who were selected from veteran associations by the snowball method. The following instruments were used in the study: General Demographic Questionnaire, Harvard Trauma Questionnaire-Bosnia and Herzegovina version and the Strengths and Difficulties Questionnaire for children. Results: Children of veterans with PTSD have more pronounced psychological and behavioral problems (U = 2372.5; P < 0.001) compared to the children of veterans without PTSD. Male children of veterans with PTSD have more frequent behavioral problems (χ2 = 7.174; P = 0.025) compared to the female children, and overall, they more frequently exhibit borderline or abnormal psychological difficulties (χ2 = 6.682; P = 0.029). Children exhibiting abnormal levels of hyperactivity are significantly younger than children who exhibit normal or borderline levels of hyperactivity (Kruskal-Wallis = 3.982; P = 0.046). Conclusions: The children of war veterans with PTSD have more psychological and behavioral problems in comparison with the children of veterans without PTSD (AU)

Background and Objectives: Understanding the mental processes preceding a suicidal act is important for the potential to intervene. This study investigates stability and possible changes of suicide methods considered during the time immediately preceding a suicide attempt. Methods: Patients who had attempted suicide were interviewed shortly thereafter with regard to whether there was a change in the conception of the method to be used during the period preceding the attempt. In addition, the course of methods applied in previous suicide attempts was assessed in attempt repeaters. Results: In total, 130 patients were included. In 63.1% one method only was envisaged during the entire suicidal crisis, in 26.9% the initial and the actual method differed. Stability rate was higher in those older than 40 years, if the duration of the suicidal crisis was less than or equal to 60 minutes and if a non violent suicide method was initially intended. Of repeaters, 46.5% used the same method in all recorded attempts. Use of a non-violent method in the first suicide attempt predicted method stability in subsequent attempts. Conclusions: Focusing on one single suicide method during the time immediately preceding a suicide attempt is common. Reduced flexibility to rapidly switch mentally to another method may contribute to explain the effectiveness of limiting access to suicide means for suicide prevention (AU)

Background and Objectives: The study aims to assess the feasibility and the level of agreement between the Spanish version GMHAT/PC diagnosis and psychiatrists' ICD-10 based clinical diagnosis. Methods: Participants in the study ranged from those who were in remission to others who had different mental illnesses. They were recruited from inpatient and outpatient mental health settings. All consecutive patients were interviewed using Spanish version of GMHAT/PC and they were assessed independently by psychiatrists to in order to get their ICD-10 based diagnosis. Results: Two hundred ninety-nine patients participated in the study. The mean duration of interview was 12.5 minutes. There is an acceptable to good level of agreement between the GP's (GMHAT/PC) diagnoses and the psychiatrists' (clinical) diagnoses of any mental illness, Kappa 0.58 95% C.I (0.46, 0.72). There is good level of sensitivity (81%) and specificity (92%), with GPs correctly identifying 242 out of the 250 participants diagnosed with mental illness and 27 out of 35 of those without. Conclusions: The finding of the study suggest that GMHAT/PC Spanish version used by GPs detected mental disorders accurately and it was feasible to use GMHAT/PC (Spanish version) in Latin America settings (AU)

Background and Objectives: The object of our study was to estimate the prevalence of psychotropic drug use among non-institutionalised elderly people 65 years or older and identify possible conditioning factors. Methods: A cross-sectional, observational study was carried out of 1161 subjects aged 65 years and older. Participants were randomly selected from health care registry listings. The main outcomes of interest were based on self-reporting and included consumption of psychotropic and other drugs (filed by the ATC Classification System), mood (based on the GDS-VE), cognitive status (Pfeiffer Questionnaire), physical-functional assessment based on Katz score, health problems (ICPC-2 classification WONCA) and socio-demographic variables. Results: The prevalence of self-reported psychotropic drug consumption was 20.5% (95% CI: 18.2 to 22.8). Anxiolytics and hypnotics were consumed by 16.6% of the elderly, antidepressants by 7.0% and antipsychotics by only 2.1%. In multivariate logistical analyses, the use of psychotropics was independently associated with other drug consumption (nonpsychotropics), (OR: 4.0, 95% CI: 1.7 to 9.5), presence of established depression (OR: 3.2, 95% CI: 1.3 to 7.6), presence of 4 or more comorbidities (OR: 2.7, 95% CI: 1.9 to 3.8), being female (OR: 2.1, 95% CI: 1.5 to 3.0) and being dependent for basic activities of daily living (OR: 1.7, 95% CI: 1.0 to 2.6). Conclusions: The prevalence of psychotropic drug use among the elderly from Albacete is high. Several factors were identified as potential determinants of psychotropic drug use. It will be important to evaluate the misuse of these drugs in order to inform effective, efficient and safe prescription strategies (AU)